One Name, Two Diseases

To add to the confusion that often surrounds diabetes, two different conditions, known as type 1 and type 2 diabetes, share the name. Both types involve insulin, the hormone that facilitates the movement of glucose into cells to be burned or stored. Simply put, type 1 diabetes reflects a problem in insulin production that results in low insulin levels. Type 2, on the other hand, reflects a problem in insulin action (also known as insulin resistance), which results in high insulin levels. Type 2 occurs mainly in adults and is the much more common form, representing 85 to 90 percent of all cases worldwide. Type 1 is more common in children, but thanks to the rapid increase in obesity among younger people, tragically this age group is also now developing type 2 diabetes. (See Are Your Kids at Risk?)

A “Silent” Disease

About one third of people with type 2 diabetes in the United States are unaware that they have this disease. Fortunately, diagnosing diabetes is as simple as checking a small amount of your blood for its blood sugar (glucose) level or your blood level of hemoglobin A1c (HbA1c), which indicates your blood glucose level over the last several months. Your health care provider can perform either of these tests at a routine checkup, and many employers provide workplace screening. Because diabetes is so common and checking for it is so easy, if you don’t know if you have diabetes, there’s no reason not to find out as soon as possible.

An Enormous Epidemic

Understanding the role of controlling carbohydrate intake in the prevention and treatment of diabetes is especially important because of the enormous scope of the diabetes epidemic. Despite the best efforts of the traditional medical approach, which is based upon aggressive use of drugs, the tide of this disease continues to rise. According to the American Diabetes Association, the disease now affects 18.2 million people in the United States, but because the early stages of diabetes can be completely silent, 8 million of them are unaware that they have the disease. Nor are the numbers likely to improve soon. As other nations adopt a diet high in sugar and processed carbohydrates, the epidemic has escalated to involve 246 million people worldwide, with projections of 380 million by 2025.